Abstract
BACKGROUND: Substance use among youth has significant implications for health, development, and society. In Mozambique, where youth form a large segment of the population, understanding the prevalence and factors associated with alcohol and drug use is essential for effective public health strategies. This study aimed to assess the prevalence and factors associated with alcohol and drug use among adolescents and young adults in Mozambique. METHODS: This study is a secondary data analysis of the 2019 Violence Against Children Survey (VACS), a nationally representative cross-sectional survey targeting individuals aged 13-24 years. Data collection were collected using face-to-face interviews with a structured questionnaire. The analysis focused on the prevalence and patterns of self-reported alcohol and drug use and identified potential socio demographic and behavioral factors associated with substance use among the youth. RESULTS: The overall prevalence of alcohol use was 29.7%, and drug use was 22.5%. Among individuals aged 18-24 years, alcohol use was significantly higher (aOR = 3.8, 95% CI: 2.9-4.9, p < 0.001) compared to those aged 13-17 years, while drug use followed a similar pattern (aOR = 2.4, 95% CI: 1.6-3.5, p < 0.001). Gender differences were observed, with females being significantly less likely to report drug use (aOR = 0.5, p < 0.001). Marital status was associated with a lower likelihood of alcohol use, as married or cohabiting individuals reported less alcohol use (aOR = 0.6, p < 0.001). Higher educational attainment was associated with an increased likelihood of alcohol use (aOR = 1.8, p < 0.001). Employment in the past 12 months was protective against both alcohol (aOR = 0.7, p < 0.001) and drug use (aOR = 0.7, p = 0.014). Notably, those who experienced sexual violence in childhood were less likely to consume alcohol (aOR = 0.4, p < 0.001) and use drugs (aOR = 0.5, p = 0.004), while those whose first sexual intercourse was pressured or forced were more likely to engage in substance use. CONCLUSION: The findings highlight the significant prevalence of alcohol and drug use among adolescents and young adults in Mozambique, with notable socio-demographic and behavioral disparities. Factors such as age, gender, marital status, educational attainment, and employment status influence substance use patterns. Additionally, traumatic experiences, including childhood sexual violence and forced or pressured first sexual intercourse, play a complex role in shaping substance use behaviors. These findings emphasize the need for integrated public health interventions that address prevention, mental health support, and socio-economic disparities to reduce substance use and promote the well-being of Mozambique's youth.